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PS-119 Effect of anticoagulation and antiplatelet therapy on the incidence of intracranial bleeding after thrombolysis in patients with acute ischaemic stroke – a pharmacoepidemiological approach
  1. L Horváth1,
  2. I Fekete2,
  3. S Márton3,
  4. K Fekete2
  1. 1University of Debrecen, Medical Centre, Central Pharmacy, Debrecen, Hungary
  2. 2University of Debrecen, Medical Centre, Department of Neurology, Debrecen, Hungary
  3. 3University of Debrecen, Faculty of Art, Institute of Political Science and Sociology, Debrecen, Hungary

Abstract

Background The rt-PA is an effective therapy in patients with acute ischaemic stroke. Well known complication of the treatment is intracranial bleeding (haemorrhagic transformation, or parenchymal haemorrhage) which can hinder the improvement and can be lethal.

Purpose Identifying the effect of anticoagulants and antiplatelet drugs, taken before the stroke, on the intracranial haemorrhage rate after rt-PA treatment.

Material and methods The Debrecen Thrombolysis Database was used. Between the 1st of January 2004 and the 31st of December 2010, 415 patients were treated with rt-PA at the Department of Neurology, University of Debrecen. For the analysis 370 patients’ data was used, who fulfilled the protocol. Odds ratio (OR) and Relative risk (RR) were calculated.

Abstract PS-119 Table 1

ResultsComparing groups A and C: ORanticoagulants = 1.48; 95% CI = 0.64–3.43; p = 0.358 and RRanticoagulants = 1.386; 95% CI = 0.70–2.73; p = 0.346 are in the group which was pre-treated with anticoagulants. Among antiplatelet drugs users (B versus C) ORantiplatelet drugs = 0.61; 95% CI = 0.17–2.1; p = 0.437 and RRantiplatelet drugs = 0.649; 95% CI = 0.21–1.97; p = 0.447 were found. If those taking anticoagulants and antiplatelet drugs were compared (A vs. B) ORanticoagulants/antiplatelet drugs = 2.41; 95% CI = 0.58–9.98; p = 0.223 and RRanticoagulants/antiplatelet drugs = 2.13; 95% CI = 0.61–7.39; p = 0.232.

Conclusion There was a non-significant trend that may suggest that antiplatelet therapy before stoke reduces the risk of intracranial bleeding, anticoagulant therapy increases it despite the acceptable INR level. Findings have to be confirmed on larger patient population.

References and/or acknowledgements No conflict of interest.

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